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TEMPORARY FOOD VENDOR’S APPLICATION <br />1.Date(s): <br />2. <br />Phone: <br />3. <br />4. <br />5. <br />6. <br />7. <br />8.the hot and cold holding of potentially hazardous <br />9. <br />meats, tamales, cooked beans, rice. <br />Page 7 of 11 TEMP EVENT APP <br />Electricity is provided for my booth's use: Yes <br />I am providing an accurate probe therm. <br />EHD 16-02 <br />08/01/16 <br />Electricity is provided for my booth's use: Yes'^No <br />I am providing an accurate probe thermogr^iter to measure <br />foods during all times of booth operation J^Yes No <br />1 an? Providing the following hot temperature control for the hot holding of all potentially hazardous foods above <br />IOO i . <br />All food vendors (both for profit and non-profit) are required to return a signed and completed copy of this checklist to <br />the festival coordinator three (3) weeks prior to this event. swieuibiiu <br />1. Name of Event: <br />The following is information about my organization/business: <br />Name of organization/busine^: <br />Address: ■' W <br /> <br />List food to be sold or given to the public: <br />I am providing food that is NOT prepared at home^WYes No <br />All food is preparedon-site or is from approved corrimercial facilities'^ Yes No <br />Name of facility:Phone: <br />Address of facility: Q) Sift \bJ- VVOlX' KTM^2-Zr| <br />' and the publS)1 f0"0Wing: (t° protect my unPacka9ed food and food-preparation areas from flies, <br />EreeShTMmnSrvTnH06-''19 constrfuc‘ed of either wood’ canvas. Plastic, similar material and fine mesh fly <br />«nh^ 9i con?pletely ®nclosin9 open food areas. It will also have a smooth and cleanable floor (concrete <br />areas• fromTe public W0°d ar6 acceptable) and constructed to separate food and food preparation <br />pother (specify): fefcR. <1 \ZVtY~VY <br />,hoss whteh beve,ases <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />JZ-I Approved bottled water. <br />X, <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify):_____________ <br />E] Camp stove | | Stemo & hotel trays <br /> Double steamer n steam table & lids <br /> Electric stove top j^Other (specify) P’PxS’ <br />Note: Examples of potentially hazardous food include: <br />vegetables, potato salad, eggs, and dairy products.